Creating a Safety Net for Individuals Experiencing Homelessness During COVID-19

In early March 2020, Dr. Jennie Wei, an Internal Medicine Physician at Gallup Indian Medical Center, attended her usual McKinley County Alcohol Task Force meeting. This gathering, however, was different. With the recent emergence of COVID-19 in the U.S., Task Force members knew that they needed to find ways to protect their most vulnerable and prevent emergency rooms from being overwhelmed. After intense discussion and quick collaboration, they decided to provide temporary housing for people experiencing homelessness, quarantining, and those who needed to isolate.

Creating Safety Through Community Collaboration

Initially the group sought out large spaces, such as school gyms and community centers, to house people. Soon they realized though that these potentially poorly ventilated open environments may further contribute to the spread of COVID-19. Inspired by low tourism rates, they began reaching out to local hotels to see if they would host individuals. To their surprise several agreed. 

According to Dr. Wei, “when we began envisioning it, a hotel-based program could cover lodging costs and provide everything patients needed.” With support provided by the two nearby hospitals and the county and state health departments, the Task Force began working with hotels to put plans in place to offer a spectrum of services, including health check-ins, meals, prescriptions, toiletries, and medical transportation.

On May 18th, 2020, Gallup had its first COVID-19 case. Within a week the hotel program housed their first patient. During the first few weeks, they housed several patients in one hotel, and Dr. Wei and Dr. Mia Lozada from the Medical Center provided daily check-ins. However, after an outbreak at a local detox facility, the program expanded to four hotels. “At this point,” said Dr. Wei “we were providing 150 rooms to individuals every day.” Between March 2020 and July 2021, the program housed over 1700 individuals for at least one night, 97% of those individuals being Native.

Dr. Wei expressed, “the hotel staff were the bravest souls. Despite all the unknowns, they were still willing to interact with people and don and doff PPE.”

Many of the program services were and continue to be provided by volunteers, who have dedicated over 8500 hours of service to date. According to Dr. Wei, “we welcomed 50+ providers from the Gallup Indian Medical Center and 45+ providers from the University of California- San Francisco, COVID Care Force, the New Mexico Medical Reserve Corps, and the Navajo Nation’s Community Outreach and Patient Empower Program.” 

From Dr. Wei’s perspective, “while COVID has hit our Gallup community incredibly hard, it has also shown what we can do when we work together to bring resources to those in need.”

Changing Lives Through Housing First

While the primary goal of the program was to decrease transmission of COVID-19, Dr. Wei says she and others have experienced firsthand how a housing first approach can change the lives of people experiencing homelessness. According to Dr. Wei, by providing for their basic needs, many individuals experiencing homelessness were able to shift their focus from housing to their medical and behavioral health needs, substance use disorder treatment, and reconnecting with family. 

Since March 2020, over 45 individuals from the hotel program have been admitted to inpatient rehab programs. Dr. Wei shares, “housing first is not only the right thing to do, but it saves precious community resources and decreases COVID community transmission.”

Providing Long-Term Security for Individuals Experiencing Homelessness

Seeing the positive results of the program encouraged the Task Force to advocate for more permanent housing options for those who were housed in the hotel program. Between November 2020 and January 2021, they collaborated with the City of Gallup to open up a Wellness Hotel to create an emergency housing program for those who were at high-risk for COVID-19 complications, including individuals experiencing homelessness. These patients were then transitioned to the Lexington Hotel, a permanent supportive housing program that opened in January 2021 in Gallup.

Additionally, they worked closely with the county and state to open the Four Corners Detox Facility, where individuals can stay up to 7 days before they transition to inpatient rehab or other long-term treatment and housing options. Since opening the detox facility, they have transitioned over 30 patients to inpatient treatment facilities.

Learn More with Indian Country ECHO

To enhance your ability to screen, treat, and manage patients with COVID-19, join one of several COVID-19 virtual clinics. Here you will participate in didactic and case presentations, receive recommendations from peers and specialists, like Dr. Wei, and join a learning community of dedicated I/T/U providers committed to growing clinical capacity so every patient across Indian Country receives the care they deserve. 

To learn more about the hotel program developed by Dr. Wei and the McKinley County Alcohol Task Force, listen to Dr. Wei’s presentation here.